ASSESSMENT OF PHOTOBIOMODULATION THERAPY IN A PATIENT WITH PSEUDOBULBAR AFFECT STATUS-POST A TRAUMATIC BRAIN INJURY: A CASE REPORT

Research Objectives: To investigate the use of Photobiomodulation Therapy (PBMT) in patients with Pseudobulbar Affect (PBA)

Design: Case Series
Patient’s follow-up period was 1 month after the appointment showcasing her episode of PBA

Setting: Private Practice: Meditech Rehabilitation Center

Participants: 57-year-old female undergoing investigational PBMT for Post-Concussion Syndrome (PCS) who presented one day with paroxysmal uncontrollable laughter simultaneous with crying which she experienced episodically and attributed to a bipolar disorder but was never diagnosed of PBA in a clinical setting

Interventions: She was undergoing investigational PBMT as part of a neurological study. She has been receiving PBMT 3 times a week for two months through external application.

Main Outcome Measures: To see reduced episodes of PBA status-post her doses of PBMT

Results: The single episode ended after providing distractions during PBMT. The Center for Neurologic Studies – Lability Scale (CNS-LS) for PBA and the Pathologic Laughing and Crying Scale (PLACS) were since administered. A score above 13 on both scales confirmed our diagnosis and PBMT was resumed. Since then, the patient rarely has PBA episodes and is now aware of the condition and is able to manage paroxysms before they occur. Symptoms for PCS likewise improved.

Conclusions: The doses of PBMT and distractions have reduced her episodes of PBA. Early diagnosis of PBA leads to significant improvements in one's quality of life and the ability to manage paroxysms before they occur. Screening tests like the CNS-LS scale for PBA and the PLACS enables physicians to differentiate PBA from various psychiatric conditions. Screening tests, along with a careful history and physical as seen in this patient supported the diagnosis of PBA. Though investigational interventions like PBMT were used to treat her, additional studies are required before this can be used in clinical settings.

Author(s) Disclosures: No funding was received for this manuscript. There is no conflict of interest among the authors either